I had to turn in a co worker...help

Keep your head up.

You did nothing wrong, if admin hadn't found anything she wouldn'a been escorted anywhere.

This nurse dragged you into a mess with narcotics that you don't need on your license.

Good job.

What a mess. No one likes to turn in a co-worker, esp. one who has been there a long time. But it would be your license if you noticed these things and didn't say anything. And what if she injured a pt due to her being high, and you didn't say anything? You would never forgive yourself. You did the right thing, and Im sure it was difficult. People will talk. Im sure they are mad about loosing a long time nurse, not specifically mad at you. They are probably mad they didn't notice similar behaviors. I hope that she receives the help that she needs, and can get her life and career back on track. You did the right thing!!

i agree that you did the right thing, absolutely!! we had a nurse that worked in our er on night shift who was caught in the act... one thing i always try to keep in mind.... what if this nurse was taking care of one of my family members... we must and always should be advocates.. good job..

I have a good friend (R.N.)with a narc addiction who was turned in and she's in recovery now. She says she might have died if she wasn't turned in and is now thankful to the nurse who turned her in. Instead of assuming everyone's talking about you try talking to people directly. If thery disagree with what you did-forget them. Don't quit-you sound like an honest, caring nurse!

Pardon my ignorance, I havent worked med surge in my nursing career, so...

With Pyxis systems, how is it that nurses can divert these narcotics, isnt there a record of who took what and when?????

Thanks for your help...

Yes with the pyxis system you log on and sign out meds under a specific patients name. All the diverter has to do is go and sign out pain meds under a patient though. If the amounts seem excessive then usually pharmacy has a little red flag and they may investigate. On a med surg floor nearly everyone usally has a prn ordered so all she would need to do is document that everyone got a requested prn.

I only know this because we had a traveler one place I worked a couple of years ago that pharmacy arrived mid shift to discuss with the charge nurse that one individual had drawn out an insane amount of narcs just part way through a shift. When they went to looking nearly none of them had been ordered. She left with the police.

Thanks everyone for your supportive comments. THere should be some mechanism in the pyxis to stop you once you've taken out the correct dose of a med, if its due only qhs, you shouldnt be allowed to take it out early or more than once that day unless you get a new order or a pharmacy overide. There is room for improvement with the pyxis system for sure.

This nurse was able to take out the pt's dose three times within 20 minutes! Yikes.

THe pyxis system can actually be set up this way. It is up to your pharmacy.

Some places I work on the floors you may only pull meds that are on the pts profile. To get anything else you must override which requires a second nurse to cosign with you. Other places you may get to whatever is in the pyxis.

Like I said though pharmacy reviews all withdrawls and if someone is taking out inordinate amounts this will raise a flag.

I had to turn in a co-worker once. I had a very busy night and was not able to chart times for several meds, so went back to the pyxis to get the activity record to get exact times to chart. In the process I noticed a co-worker had removed a large amt of a narcotic on my pt. I then went back and checked her activity record (it keeps the last 24 hrs, probably more for the pharmacists) and she had taken some on another pt (who was not ordered for it so she used override, no witness needed then) I printed this info out, wrote a letter to nurse manager, got feedback from a fellow co-worker who agreed with my findings and we never saw her at work again. Other co-workers wondered and wondered what happened to her but I don't know if anyone ever found out. I asked to be anonymous. A couple years later I saw her name in the state board of nursings list of RN's as one who voluntarilly surrendered her license. I was shocked, but now I know it can happen.... I was very sad, she was fun to work with.

In the process I noticed a co-worker had removed a large amt of a narcotic on my pt.

The problem w/ diverting is that you CAN just take out PRNs that you don't give for your pts and keep them for yourself.

THIS WILL WORK. But, only for awhile.

But the nature of addiction is like a law of nature. As that addiction grows, a nurse will be unable to conceal diversion in that way. And the result is ever more 'daring' behavior: overriding for narcs not ordered, or, more likely, withdrawing PRN narcs for pts they aren't taking care of. That's easier to conceal.

I've worked on big units and seen my share of diverters. I ALWAYS, as a standard of care for my pts, check the 'pt usage' on all my pts at the end of my shift. If somebody else signed out a narc on one of MY pts that I didn't personally request they give for me: I write that up to my manager AND send a note to pharmacy. I've had to do that twice in my career. First time, after investigation, it was an honest mistake (signed out a sedative on MY pt; meant to sign out the same sedative on the pt next to mine on the pyxis list.) The other time: diverter.

It's such a simple matter for a diligent pharmacy to catch diverters. A simple standard deviation plot is all it would take. Diverters would be so far outside the standard deviation that they would make the most aggressive pain control nurse look tame by comparison.

I don't know why hospitals aren't more diligent about this. Maybe they don't WANT to know - and that's scary. Bottom line: this shouldn't have been left up to you; it should have been caught before. You maybe could have been more discreet and anonymous but that's water under the bridge.

Be cool for awhile. Sometimes things do blow over. But, you may find that you DO need to find another job. In any case, you did the right thing. Doing the right thing sometimes costs. I would give it some time. The people mad at you know you did the right thing, even as they 'rally' around their friend.

~faith,

Timothy.

Thanks everyone for your supportive comments. THere should be some mechanism in the pyxis to stop you once you've taken out the correct dose of a med, if its due only qhs, you shouldnt be allowed to take it out early or more than once that day unless you get a new order or a pharmacy overide. There is room for improvement with the pyxis system for sure.

This nurse was able to take out the pt's dose three times within 20 minutes! Yikes.

When an addict steals drugs so blatently on the job, she/he is in the advanced state of the disease. Death often follows. There's not much we can do to prevent an addict from stealing - we can only make it easier to find them. You might be surprised how many nurses would have done nothing. When you have time, go to AANA.com and click on peer assistance where there is lots if information re: addictions on the job.